Eden Christian Henry, in Gallup, NM

Eden Christian Henry, is a medicare enrolled "Pediatrics" physician in Gallup, New Mexico. Her current practice location is 516 E Nizhoni Blvd, Gallup, New Mexico. You can reach out to her office (for appointments etc.) via phone at (505) 722-1000.

Eden Christian Henry is licensed to practice in Florida (license number 175086) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114509650.

Contact Information

	Eden Christian Henry,
	516 E Nizhoni Blvd, Gallup, NM 87301-5748
	(505) 722-1000
	Not Available

Map and Direction

Physician's Profile

Full Name	Eden Christian Henry
Gender	Female
Speciality	Pediatrics
Location	516 E Nizhoni Blvd, Gallup, New Mexico
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114509650
Provider Enumeration Date: 04/23/2021
Last Update Date: 09/29/2025

Medicare PECOS Information:

PECOS PAC ID: 6800298522
Enrollment ID: I20250317001809

Medical Identifiers

Medical identifiers for Eden Christian Henry such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114509650	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	0420017989 (Vermont)	Secondary
208000000X	Pediatrics	CDR.0005149 (Colorado)	Secondary
208000000X	Pediatrics	TL8632 (Wyoming)	Secondary
208000000X	Pediatrics	V6597 (Texas)	Secondary
208000000X	Pediatrics	175086 (Florida)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Eden Christian Henry allows following entities to bill medicare on her behalf.

Entity Name	Memorial Hospital Of Sweetwater County
Entity Type	Part A Provider - Critical Access Hospital
Entity Identifiers	NPI Number: 1558361949 PECOS PAC ID: 0244124550 Enrollment ID: O20230717002172

Entity Name	Banner Hospital Based Physicians West Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1619464120 PECOS PAC ID: 5799131579 Enrollment ID: O20231031001364

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Eden Christian Henry is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Eden Christian Henry, 6102 Private Road 6470, Lubbock, TX 79416-3351 Ph: (806) 789-4871	Eden Christian Henry, 516 E Nizhoni Blvd, Gallup, NM 87301-5748 Ph: (505) 722-1000

Reviews and Comments

Pediatrics Doctors in Gallup, NM

Dr. Carlos Manuel De Sanctis, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 516 E. Nizhoni Blvd., Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1268
Ramona V. Anderson, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 516 East Nizhoni Blvd., Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1268
Dr. John Edward Ratmeyer, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 516 Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1268
Michelle Stam-maclaren, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2111 College Drive, Rehoboth Mckinley Christian Health Care Services, Gallup, NM 87301 Phone: 505-863-1820
Janet M Li-tempest, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 516 Nizhoni Blvd, Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1268
Gary A Escudero, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 516 E. Nizhoni Blvd, Box 1337, Gallup, NM 87301 Phone: 505-722-1000 Fax: 505-722-1397

Eden Christian Henry, - Medicare Pediatrics in Gallup, NM